How to get over feeling squeamish with trachs

ChristineN, BSN, RN · Oct 25, 2011

Volunteer to help whenever there is a pt needing trach care on your floor.

Ask another nurse to help you whenever you have to do trach care.

FLArn · Oct 25, 2011

The nervousness in dealing with airways will get better with more experience just like any other skill. The dealing with sputum will become a little easier but probably won't go away entirely. I just suction a little more frequently if the patient has a lot of secretions. Also adding moisture to keep the secretions thin helps a lot with the queasy factor.

xtxrn, ASN, RN · Oct 25, 2011

Practice, practice, practice....

If you can, get behind the HOB, and be sure the patient is moved up in bed appropriately, so you can reach around from the back, and suction without being in the line of fire. It helped me more than once :)

When I was a fairly new nurse (

Horseshoe, BSN, RN · Oct 25, 2011

Agree with all of the above. You can become very proficient and less "sqeamish," but it's also possible that you will simply become very proficient. Most nurses have at least one thing that really gets their gag reflex going. For some, it's blood, other's vomit or feces, etc. For me, it's trachs and infected lung material with vented patients. Phlegm in general. It was a huge challenge for me when I was in ICU.

I've moved on to a different specialty with no trachs, but the other day I had to suction a patient with thick, copius secretions, and it took every ounce of self control I had not to barf.

DogWmn · Oct 25, 2011

Practice, practice, practice....
When I was a fairly new nurse (

LOL Bruhahaha, Oh how I remember those days with those huge glass jugs...blech.

netglow, ASN, RN · Oct 25, 2011

OK, maybe I shouldn't have read this. Really wasn't a problem for me before, but reading all this stuff kinda puts a little more focus on the whole deal.

Memories:

Worked for a doc who came up to me when we both had bad sinus infections. He said, "Geez netglow, my nose has been running behind my mask, you should see how much green snot is in there since we've been with that patient!!" Nope, no thanks doc, I'll take your word for it. :rolleyes:

I do, however use a nettie pot myself if I get sick. This doc, refused my teaching him. He was afraid he'd drown himself. :rolleyes:

umcRN, BSN, RN · Oct 25, 2011

Been caring for trach patients for 2.5 years now...all secretions whether from trach, ETT, nose or stomach (bile, ick!) completely grosses me out and makes me feel like gagging a little. Oh well! I deal, I was even a primary RN for two trach patients during my time in the NICU, I loved them enough to get over it haha

BrandybunsRN · Oct 25, 2011

I've been a nurse for about 15 years and I still hate sputum. It grosses me out! (lol). I've been a cardiac nurse my whole career and I would happily take just about any other fluid over sputum. For me, I never got over it. I don't make any fuss in front of the patient, but I've had to step out of the room before because I knew I was going to gag. *shrug* Just one of those things for me I guess!

I used to work with a nurse that hated poop, and I mean he hated it! So we used to trade.... I would wipe butts and he would clean trachs/etc. It was a system that worked great for the two of us. Not that I "like" the poo part, I just didn't get as sicj dealing with it as I did with sputum! LOL

trauma_lama, BSN · Oct 25, 2011

ugh i'm so glad to hear someone else say this...i watched a suction last week in clinical and i put my "game face" on but inside i could literally feel my breakfast creeping up from my stomach towards my throat. urrrrghhhhhhh and also on an unrelated note: learning about wounds right now. i'm okay with the pretty pink surg/post op wounds but OMG debriding and all that ghhhaaaaaaaaaaaaaa :barf01:lets just say i'm not as bada$$ and tough as i thought i was with the gross factor. bllllllarhhhggggggggggggggg i need to toughen up, STAT!

BrandybunsRN · Oct 26, 2011

ugh i'm so glad to hear someone else say this...i watched a suction last week in clinical and i put my "game face" on but inside i could literally feel my breakfast creeping up from my stomach towards my throat. urrrrghhhhhhh and also on an unrelated note: learning about wounds right now. i'm okay with the pretty pink surg/post op wounds but OMG debriding and all that ghhhaaaaaaaaaaaaaa :barf01:lets just say i'm not as bada$$ and tough as i thought i was with the gross factor. bllllllarhhhggggggggggggggg i need to toughen up, STAT!

LOL!!! I was ok with wounds until the first time I saw a tunneling wound and pulled 3 feet of gauze out of a man's leg. I barely made it through re-packing before I ran outta the room and lost my lunch. lol

Horseshoe, BSN, RN · Oct 26, 2011

ugh i'm so glad to hear someone else say this...i watched a suction last week in clinical and i put my "game face" on but inside i could literally feel my breakfast creeping up from my stomach towards my throat. urrrrghhhhhhh and also on an unrelated note: learning about wounds right now. i'm okay with the pretty pink surg/post op wounds but OMG debriding and all that ghhhaaaaaaaaaaaaaa :barf01:lets just say i'm not as bada$$ and tough as i thought i was with the gross factor. bllllllarhhhggggggggggggggg i need to toughen up, STAT!

I thought I was pretty tough, too. In nursing school, I was working in a large metropolitan hospital intensive care unit. We had an obese patient who had been injecting a recreational drug into the back of the thighs/buttocks. This drug did not have intended effects by being injected into adipose tissue, so I have no idea why this was being done. The patient developed infection/necrotizing fasciitis. The entire posterior low back/buttocks/thighs were eaten by this bacteria. I had to help the residents pull out all of the packing to apply bacterial rinses/debride, etc. They pulled out packs and packs and packs out of these cavernous wounds. It seemed like I was in a meat packing facility rather than a hospital. I couldn't believe my eyes, couldn't believe this patient was alive, much less tolerating the pain of this condition. As they pulled out the umpteenth wad of packing out of this patient, I glimpsed the vertebrae of the low back. Here came the white spots, then the nausea, then the feeling of seeing and hearing the goings on from a distance. GONE.

One of the residents helped me up and out of the room. I was about to thank him when he curtly told me I would never be able to be a nurse if I didn't "toughen up."

So, it happens. That probably wouldn't faze me now.